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General NPI Number Information
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NPI Number | 1942443387
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Entity Type | Organization
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Legal Business Name | DIABETES HEALTHCARE OF NH
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 63 LISA DR
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City | GOFFSTOWN
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State | NH
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Zip | 03045-2833
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Country | US
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Telephone | 603-660-6780
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Fax |
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Provider Business Mailing Address
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Address Line | 63 LISA DR
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City | GOFFSTOWN
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State | NH
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Zip | 03045-2833
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Country | US
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Telephone | 603-660-6780
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JAMES MERVILLE HARRIS JR.
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Credential | ARNP
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Telephone | 603-660-6780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 041658
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License Number State | NH
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